Cancer is a major cause of illness in Australia and also has substantial social and economic impacts on individuals, families and the community. Many Aboriginal and Torres Strait Islander people have been affected by cancer which is a major contributor to the burden of disease among this population.
The Review of cancer among Aboriginal and Torres Strait Islander people delivers a comprehensive synthesis of key information on cancer among Aboriginal and Torres Strait Islander people in Australia to inform those involved or interested in Aboriginal and Torres Strait Islander health; and provides the evidence for those involved in policy, strategy and program development and delivery.
The review, written by University of Western Australia staff, in conjunction with Australian Indigenous HealthInfoNet staff, provides information on factors that contribute to cancer among Aboriginal and Torres Strait Islander people. Details of the extent of cancer among Aboriginal and Torres Strait Islander people include information on incidence, prevalence, survival mortality, burden of disease and health service utilisation. The review discusses the issues of prevention and management of cancer, and provides information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people. It concludes by discussing possible future directions for combatting cancer in Australia.
HealthInfoNet Director, Professor Neil Drew said, "The review shows that cultural safety in service provision, increased participation in breast, bowel and cervical screening and reduction in risk factors will improve outcomes for cancer among Aboriginal and Torres Strait Islander people."
Research by the Australian Institute of Health and Welfare has found that Aboriginal and Torres Strait Islander people experience a higher incidence of cancer and a lower survival rate compared with non-Indigenous Australians. The most common cancers diagnosed among Aboriginal and Torres Strait Islander people are lung, breast (females), colorectal (bowel) and prostate (males). To some extent, the survival disparity reflects higher rates of cancer with a poor prognosis and later staging at diagnosis, but this does not account for all of the difference in survival rates. Attention must be given to the way in which health services meet the needs of Aboriginal and Torres Strait Islander people.
A combination of broad historical influences and social and cultural determinants, as well as proximal health risk factors and the delivery of cancer services are associated with cancer outcomes among Aboriginal and Torres Strait Islander people. Social and cultural determinants not only influence risk factors for cancer but also health seeking behaviour and therefore participation in cancer screening programs, willingness to present to health providers with symptoms, and the timeliness of diagnosis and uptake and adherence to recommended treatment.
Effective cancer management through early detection programs; a culturally competent workforce; cancer support groups; assessment of the unmet support needs of patients diagnosed with cancer; and improved links between Aboriginal and Torres Strait Islander communities, primary health care providers and mainstream cancer care services could assist in sustained improvements in cancer care and health outcomes for Aboriginal and Torres Strait Islander people.
The National Aboriginal and Torres Strait Islander Cancer Framework, published by the Cancer Council in 2015 is significant as the first national approach to addressing the gap in cancer outcomes that currently exists between Aboriginal and Torres Strait Islander people and the non-Indigenous population. It provides guidance for individuals, communities, organisations and governments has been responsible for gathering national support and agreement on the priorities and for creating a high level of expectation around the ability to address the growing cancer disparity.